Gynaecological problems in women with rheumatoid arthritis

by Dr. Archana Ravindra Shinde

Our immune system protects us from diseases.Ideally, antibodies, which are part of the immune system, recognize and destroy infections like bacteria and viruses so we do not get sick. To do this successfully, our body must be able to distinguish between "self" and "non-self" (e.g. bacteria and viruses).

Autoimmune diseases occur when the body misinterprets "self" and "non-self", resulting in the destruction of its own cells. The causes of autoimmune disease are unclear. It appears that multiple genes work together to make an individual vulnerable and ultimately, a trigger occurs that disrupts proper functioning of the immune system.

The trigger may be an infection, medication, or environmental exposure, but often it is unknown.

Approximately 5% of the population in Western counties have autoimmune diseases. Of people with autoimmune conditions, 75% are women. The two most common conditions are rheumatoid arthritis and autoimmune thyroiditis. Other types, while relatively rare, include multiple sclerosis, psoriasis and lupus.

Role of gynaecologist

Although primary care clinicians and Gynaecologists might not see large numbers of women with RA in their practices, the demographics related to this disease make it clear that they will undoubtedly encounter some. The overall prevalence of RA is approximately three times greater in women than in men. It is not understood why women are more likely to develop rheumatoid arthritis than men. However, research continues in this area and there are several theories that exist.

The most prominent theory about the development of rheumatoid arthritis being more common in women is associated with changes in the levels of sex hormones, including estrogen and progesterone. These sex hormones have critical roles in the inflammatory response and in the overall regulation of the immune system.

Gynaecological problems are as common in rheumatoid arthritis patients as in the general population.

They can be categorised into two groups :

The most common gynaecological problems in perimenopausal age group are :
Whereas those commonly seen in post menopausal women are